Wax model collection of the Department of Dermatology, University of Münster

Between the 17^th century and the middle of the 20^th century, wax models were widely used for training in anatomy and other medical fields, especially dermatology. Thereafter, photographic techniques led to the replacement and subsequent dissolution of many European wax model collections. Unfortunately many wax models lose their original colors over time. Since only few mouleurs (wax artists) are still active in Europe conserving wax models, the “dying of moulages” cannot be stopped. Consequently, the existing wax models are of medical and historical interest since they reflect the development of our speciality. The Department of Dermatology in Münster is in the possession of 121 wax models, which are presented in this article.     

Daylight photodynamic therapy versus cryosurgery for the treatment and prophylaxis of actinic keratoses of the face − protocol of a multicenter,prospective, randomized,controlled, two-armed study

Background

Photodynamic therapy with daylight (DL-PDT) is efficacious in treating actinic keratosis (AK), but the efficacy of field-directed, repetitive DL-PDT for the treatment and prophylaxis of AK in photodamaged facial skin has not yet been investigated.

Methods/design

In this multicenter, prospective, randomized, controlled, two-armed, observer-blinded trial, patients with a minimum of 5 mild-to-moderate AK lesions on photodamaged facial skin are randomly allocated to two treatment groups: DL-PDT with methyl aminolevulinate (MAL) and cryosurgery. In the DL-PDT group (experimental group), 5 treatments of the entire face are conducted over the course of 18 months. After preparation of the lesion and within 30 min after MAL application, patients expose themselves to daylight for 2 h. In the control group, lesion-directed cryosurgery is conducted at the first visit and, in the case of uncleared or new AK lesions, also at visits 2 to 5. The efficacy of the treatment is evaluated at visits 2 to 6 by documenting all existing and new AK lesions in the face. Cosmetic results and improvement of photoaging parameters are evaluated by means of a modified Dover scale.Primary outcome parameter is the cumulative number of AK lesions observed between visits 2 and 6.Secondary outcome parameters are complete clearance of AK, new AK lesions since the previous visit, cosmetic results independently evaluated by both patient and physician, patient-reported pain (visual analogue scale), patient and physician satisfaction scores with cosmetic results, and patient-reported quality of life (Dermatology Life Quality Index). Safety parameters are also documented (adverse events and serious adverse events).

Discussion

This clinical trial will assess the efficacy of repetitive DL-PDT in preventing AK and investigate possible rejuvenating effects of this treatment. (Trial registration: ClinicalTrials.gov Identifier: NCT02736760).

Trial registration

ClinicalTrials.gov Identifier: NCT02736760. Study Code Daylight_01. EudraCT 2014–005121-13.

     

Proceedings of the Facial Aesthetics Conference and Exhibition,Royal College of Physicians,London, 24–25 June 2006

BACKGROUND: Treatment of acne scarring is a challenging problem for dermatologists and cosmetic surgeons. Combining skin resurfacing with other procedures, especially the use of filling agents, has proven to be superior to the use of a single modality. Carbon dioxide laser resurfacing has been popularized for the treatment of acne scarring, but post operative morbidity with stimulation of active acne has been problematic. Conventional erbium resurfacing is effective when sufficient fluences are used, particularly when treating relatively superficial acne scars. Deeper resurfacing for acne scars is difficult with erbium lasers, owing to bleeding and heavy exudation, which decreases ablation efficiency and makes 'end points' difficult to visualize. The newer modulated hybrid erbium/CO 2 lasers (Derma K, ESC Sharplan, Yokneam, Israel) produce efficient ablation by the reduction of bleeding, yet at the same time incur little post operative morbidity. This is suitable for treating deeper acne scars, and may be combined with other procedures, e.g. fat grafting. Of particular importance is the lack of acne stimulation associated with the use of the erbium/CO 2 hybrid lasers. RESULTS: In my series of 78 patients, improvement in acne scarring was >70% in the majority of patients. Post operative morbidity and complications were minor compared to conventional CO 2 laser resurfacing.     

A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero ® Basic versus Restylane ® for correction of nasolabial folds

The aim of this prospective, rater-blind, randomized, intra-individual, 4-week study was to compare the effectiveness and safety of two hyaluronic acid dermal fillers, Belotero? Basic (monophasic) and Restylane? (biphasic), for correction of nasolabial folds (NLF). Twenty subjects with bilateral, symmetrical NLF were randomized to receive a single injection of Belotero? Basic and Restylane? in a split-face design. The primary endpoint measured intra-individual differences of treatment effects in mean depth and evenness of the NLF target area relative to its edges, from baseline to Week 4, as evaluated by the Phase-shift Rapid In-vivo Measurement of Skin (PRIMOS) system. Assessments were undertaken at Visit 2 (baseline) and Visit 3 (study endpoint). Treatment with Belotero? Basic resulted in a significantly greater improvement in evenness compared with Restylane? at Week 4 (mean intra-individual difference between treatments in PRIMOS measurement: -37.6 μm; 95% CI: -65.4; -9.9). Subject-rated secondary endpoints demonstrated numerical differences in favour of Belotero? Basic when compared with Restylane?. Both dermal fillers were equally well tolerated, as 85% (Belotero? Basic group) and 80% (Restylane? group) rated the tolerability of both treatments as "good" to "very good".     

Prevalence and incidence of pressure injuries in pediatric hospitals in the city of São Paulo,SP, Brazil

Objective

To identify the incidence and prevalence of pressure injuries (PIs) in children admitted to hospitals in the city of São Paulo, and assess the association between sociodemographic and clinical characteristics with hospital-acquired pressure injuries (HAPIs).